“Despite more than sixty years of government efforts—representing the work of both political parties—we are moving further and further away from what we want. Prices are higher, more people are excluded from needed care, more excess treatments are performed, and more people die from preventable errors. Why?”

Why, indeed! Having had the Affordable Care Act (ACA) forced on us by a Democrat-controlled Congress—some of whom had to be bribed for their vote—Americans are beginning to learn that the cost of healthcare is going to increase, people will be laid off, have their hours reduced, or simply not hired at all as the result of this horrid new law.

A February 25 Rasmussen poll revealed that “Most voters still believe that President Obama’s national health law will cost more than official estimates and expect it to drive up the cost of health care in America.” They’re right!

David Goldhill has performed a national service with his new book, “Catastrophic Care: How American Health Care Killed My Father and How to Fix It.” ($25.95, Alfred A. Knopf) Goldhill is the president and chief executive officer of GSN, which operates a U.S. cable television network seen in more than 75 million homes and is one of the world’s largest digital games companies. He came to the issues of healthcare in the wake of his father’s death.

“Although his death was a deeply personal and unique tragedy for me and my family, my dad was merely one of a hundred thousand Americans who died that year as the result of infections picked up in hospitals. A hundred thousand preventable deaths! That’s more than double the annual number of people killed in car crashes, five times the number murdered, twenty 9/11s. Each and every year!”

“All of the actors in health care want to serve patients well, but understandably most respond rationally to the backward economic incentives baked into the system,” writes Goldhill. “At the heart of these perverse incentives is insurance. Unlike with everything else in the economy we rely on insurance as the sole means of paying for everything in health care—from the most routine to the most urgent.”

Noting that “Our massive and failing Medicare and Medicaid programs are already unsustainable and unfixable”, a fact known to anyone paying any attention, Goldhill gets to the heart of Obamacare, whose “central thrust is for ever more insurance to pay for health care.” The result is that “the underlying insurance-based structure of our health care system drives excess treatment, cost inflation, and medical errors.”

There are many myths about healthcare that have become embedded in our society. Goldhill notes that “The factors that most predict your health are your wealth, education, and lifestyle—not your access to health care.” This might seem self-evident, but we live in a nation where we are constantly hectored regarding our lifestyle choices; what and how much we eat, whether we exercise sufficiently, and endless articles suggesting that diseases and illness is predicated, not on our genetic liabilities (if you come from a family with a history of heart disease or cancer), but on the literal invention of new ailments driven by pharmaceutical innovations to “cure” them.

“The ACA (Obamacare) is fundamentally a health insurance bill, not a real piece of health care reform legislation, focusing as it does on the wrapper of insurance rather than on the complex and dysfunctional system inside.”

To understand where we are today, we need to understand that so-called health insurance is “a payment mechanism for health care”, not the health care itself. It influences that nature of the actual healthcare being provided. Moreover, “The U.S. health insurance companies employ over a half a million workers. That’s one worker for every two doctors. The administrative cost of managing our system of health care payments alne is almost $1,000 per American household. For most Americans, their annual share of this administrative cost exceeds the amount of actual health care they use in a typical year.”

“It is estimated that over the next decade the ACA will cost the government at least $1 trillion and the uninsured themselves the same amount,” says Goldhill. It’s worth keeping in mind at this point that the U.S. is $16 trillion in debt already and Medicare is widely understood to be underfunded; in part because $716 billion was taken from it to fund the imposition of ACA on the nation.

“In any given year, the most costly five percent of people account for more than fifty percent of health-care costs, and the top ten percent of people account for seventy percent of costs.” In effect this means that insurance is the mechanism “for moving funds from the many well to the few ill.” As a result, Medicare and the insurance companies become “surrogates” who “negotiate prices and preapprove procedures” and “they increasingly determine your choice of doctors.”

Goldhill notes that “there are plenty of government aid programs—food stamps, welfare, Social Security—in which the government doesn’t determine how we will spend its money, must less the prices of goods and services and from whom we can buy them.”

The kicker is that “health insurers can achieve long term profit growth only if the amount of money spent on health care increases!

Goldhill concludes that “Overall, the surrogates have done a miserable job of regulating the system’s quality, safety, and price.”

That is where we are today and it will get worse in the future. And our lives depend on the present system.

Government meddling driving doctors from medicine

By Dr. Constance Uribe

Americans are so focused on the availability of health care provided by the Affordable Care Act that they completely overlook the quality of care they might receive. Government interference, intrusive mandates and cumbersome regulations are making it impossible to continue providing high-quality care.

Physicians across the nation have been planning for the worst, and an exodus of more than 100,000 doctors is expected by 2020. I will be closing the doors of my office in December after 32 years in surgical practice.

Patients will be lucky to see a physician because fewer will be available. The government does not recognize the term “physician” anymore. A fully trained doctor of medicine or doctor of osteopathic medicine who completed a residency and became board-certified will be rare because the lesser-trained licensed health care provider will be the norm.

Since the 1980s, my career has been riddled with regulations created by a government bent on controlling every aspect of patients’ lives. The coup de grace was delivered by the Affordable Care Act, but the blindfold was placed by President George W. Bush.

To insure buy-in from all health care providers, the government had to create meaningful incentives, the first of these being marginal payback for compliance. What started out as voluntary soon became mandatory. While physicians may have received partial reimbursements from the government to equip their offices with the computer systems, these did not come close to meeting the costs of implementation.

Mandates meant as meaningful incentives are quickly turning into penalties. Physicians see deductions on already-lowered Medicare payments because of failure to use e-prescribing. They are threatened with further deductions if they do not have electronic medical records in place by 2014.

The practicing physician is buried in more mandates, more regulations and more penalties. As entry of patient data into the computer becomes more burdensome, it does not take long to discover that the system has been designed for auditing purposes, not for charting purposes.

Not only are health records no longer protected within the walls of a medical office, but physicians are complaining about the time consumption, computer errors and false sense of security created as a scheme rather than a service. One physician wrote on a blog, “It adds an hour of work to my day and makes my office notes sound like they were written by an imbecile.”

From the patient’s viewpoint, the physician has turned his attention to clicking computer keys with eyes glued to the screen. Data entry now takes priority over quality time.

The Affordable Care Act will finish driving the wedge between the doctor and the patient and put an end to a once-sacred relationship. Not only will the current mandates remain in place, but physicians will be inundated with the new insurance exchange identification numbers, authorizations, codes and denials.

My office staff puts the patient’s interest first and tries to follow Medicare guidelines, yet we have problems getting insurance carriers to cover routine procedures without writing letters and making myriad phone calls. With my upcoming retirement comes the relief of no longer screaming four-letter words into the phone at uneducated bureaucrats and medical directors committed to pigeonholing people and withholding care.

The health information technology storehouse gives the government more ammunition to track physicians, enforce new evidence-based standards and grade physicians accordingly. The grading, called “pay for performance,” will be another way for the government to cut costs under the guise of improving health care.

If the health care provider fails in a certain category such as infection rate or mortality rate, his reimbursement will be affected. With this type of incentive for physicians, high-risk patients will have difficulty finding access to quality care. The art of medicine is becoming the trade of medicine.

The health information technology storehouse and the Affordable Care will rip total control of patient care from the hands of physicians. Anyone who believes differently is as delusional as the congressional leaders who passed the legislation in the first place. Then again, no one bothered to read it.

Dr. Constance Uribe is a general surgeon and author of “The Health Care Provider’s Guide to Facing the Malpractice Deposition” (CRC Press, 1999).

This was the question asked by Illinois congressman Peter Roskam: “How about when the president said you can keep your health care coverage if you like it? And yet, the reality is, according to Bloomberg at least, 9 percent fewer businesses are offering medical coverage than in 2010. There the rhetoric didn’t meet the reality, did it?”

Sebelius responded, “Well again, Congressman, what you’re seeing – It wouldn’t have mattered if we had passed the Affordable Care Act or not. The private market is in a death spiral.”

Sebelius’s testimony directly contradicts a McKinsey study released last year. “At least 30 percent of employers are likely to stop offering health insurance once provisions of the U.S. health care reform law kick in in 2014, according to a study by consultant McKinsey,” Reuters reported. “McKinsey, which based its projection on a survey of more than 1,300 employers of various sizes and industries and other proprietary research, found that 30 percent of employers will ‘definitely’ or ‘probably’ stop offering coverage in the years after 2014, when new medical insurance exchanges are supposed to be up and running.”

Washington DC is full of stupid people. Not everyone in DC is stupid. Just a majority.

This evening, as I was leaving CPAC, a late model mini-van was in front of me and it has a bumper sticker on the back of it that said, “Healthcare for all, not for profit.”

That is liberalism for you. It is nothing more than a soundbite and a stupid soundbite at that.

Liberals hate profit, for reasons that simply cannot be explained except by a catastrophic failure of intelligence.

I would love to debate one of these liberals who think that profit, particularly in the healthcare industry is a bad thing. Let’s start with the medical personnel. Do Doctors go to med school to help the world? Possibly but a six figure income is also a strong inducement. Nurses go to nursing school to help people but also to make a good living. The same is true for technicians.

Let’s ask the same liberal, do you want the highest paid doctor working on you or the lowest paid? I want the highest paid, since our society rewards excellence with money. The guy who is the lowest paid is probably the worst doctor.

Speaking of which, suppose we took the profit motive out of medicine. Let’s cut the wages of doctors down to minimum wage. What kind of doctors would we end up with? Would you want that doctor working on you?

What about those great medicines we have? We have medicines today that 10 or 20 years ago did not exist and are considered miraculous today. Why? Because a pharmaceutical company took a risk, invested billions into a medicine and now makes a profit from that medicine.

What about those incredible medical devices we have now? Thirty years ago, an appendectomy meant a major abdominal incision. Now, most of the time it can be done with robotic tools. Why do we have them? Because companies can make a profit developing these tools and selling them.

Are liberals really that dumb?

In a word, yes.

Liberals want to give us a profit-less health care system.

Is that bad? Well let’s look at the kind of system liberals think we should have. In England, they have the National Health Service. People wait months for appointments. In some parts of Britain, people are forced to pull their own teeth because of a shortage of dentists. As a cost cutting measure, instead of washing sheets between patient use, the NHS is just going to turn the sheets inside out.

Perhaps the person driving that minivan should have had a hypocrisy bumper sticker next to their silly liberal healthcare bumper sticker.

Who knows what this person did. They probably worked for the government. What ever it is, do you think they worked because they get a good salary. Ooops, there is that evil profit again. This time it is personal profit.

Have you ever noticed all of these liberals who complain about profit, yet they enjoy the benefits of personal profit? Have you seen the “Occu-tards” with their designer clothes, their REI tents and sleeping bags, their IPhones, Ipads and laptops? Someone made money to pay for those items.

Ooops.

There is that evil profit word again.

Liberals love to spend other people’s money. They also hate profit. As long as it is other people’s profits they are railing against.

SAN DIEGO, February 1, 2012 – Multiple physician groups have come out in strong opposition to the Obamacare legislation and to the under-handed, self-serving fashion in which the American Medical Association (AMA) gave its support for the law. The AMA sought to curry favor with the government to preserve their lucrative royalty monopoly on the medical billing codes that must be used to file all medical claims in the United States. These codes netted the AMA 72 million in the year 2010 alone, and evidently provided enough incentive that the AMA all but ignored the will of the majority of doctors in the country in their Obamacare endorsement.

“There is a reason that most doctors are not members of the AMA,” says Richard Willner, executive VP of America’s Medical Society (AMS), an AMA competitor. “Only 15% of doctors practicing in the community are members of the AMA because the AMA has ignored them, disregarded their ideas, and chosen money over principle in the battle to preserve the doctor-patient relationship.”

The following draft of ‘Ten Commandments for Healthcare Reform’ was authored by Marcy Zwelling-Aamot, M.D., Chairman of the Board and former President of AAPP; along with AMS President/Founder, Adam F. Dorin, M.D., MBA, Doctor Zwelling-Aamot is spearheading the 2012 doctors coalition meeting later this Spring in San Diego:

I. The patient/doctor relationship is confidential and personal. It should never be regulated by outside agencies.

II. Our patients’ privacy cannot be compromised.

III. Patients should always be free to choose their own doctor, hospital, and treatment plan. The patient and physician working together in trusted collaboration should make decisions about their medical care.

IV. Patients have the right to privately contract with any physician, provider, healthcare facility, or vendor that provides health related materials. Fee schedules and price lists should be readily available.

V. Actuarial risk is the business of payers, not health care providers. Insurers should assume the actuarial risk of those with pre-existing conditions by setting up high-risk pools. Insurers should make basic catastrophic, hospital only insurance available for individuals to purchase and own.

VI. Payment of benefits is between the payer (either private or public) and the insured. Payment for services should be between the patient and the doctor, hospital or other provider of care. The two should not be mixed.

VII. Any tax benefit provided for the purchase of health care or health insurance should accrue to the individual patient/insured. Employers may contribute to their employee’s health benefit without tax implications. Insurance contracts should remain under the jurisdiction of contract law in the state where the insurance is purchased and insurance should be able to be purchased across state lines.

VIII. There shall be no mandates.

IX: The right for justice must be secured for patients injured in the medical system. Doctors and caregivers should be protected from negligent abuse of the system.

X. The patient should determine quality of healthcare. Standards of care are the discretion of specialty organizations and should be published and available to all patients. Physicians within that specialty network should do peer review exclusively and confidentially.

One of the purposes of the physician coalition group meeting is to further clarify, perhaps modify, and expand upon the principles set forth in the healthcare ‘ten commandments’. The events organizers believe that true physician representation was lacking in the creation of the ‘Affordable Care Act’, and they seek to influence the discussion in a constructive manner as heated legal and political challenges to Obamacare are underway.

According to a recent Deloitte Center for Health Solutions study, and others since the passage of the ‘Act’, the combination of more low-paying health insurance patients and fewer doctors to care for them will be a “recipe for disaster.” Only one in three consumers still support the Obamacare law, and, according to President Mike Dillon of InstantHealthInsuranceQuotes.com, an increasing number of physicians who originally supported the AMA and the new law are changing their minds. Estimates are that the country will be 160,000 physicians short by the year 2025. With the AMA losing a known 12,000 members in the year 2010 alone because of their support for Obamacare, and an undisclosed number of additional membership defectors suspected to have impacted the AMA in the year 2011, it is clear that doctors are very concerned about the quality, fiscal, and practice management implications of healthcare reform in its current form.

The coalition of non-AMA doctor groups is concerned not only with patient access and the preservation of the sacred doctor-patient relationship, but also with the onerous rules that will be created and controlled by local, Obamacare-mandated Accountable Care Organizations (ACOs). These mini-HMOs will deprive patients of the right to a full-range of pharmaceutical options and will restrict treatment choices and locations. ACOs will further expand confusing and often dangerous layers of bureaucracy in the form of specialty-tier drug pricing, ‘prior authorization’ requirements for medical visits and procedures, and opaque ‘medical necessity’ restrictions.

The coalition group of physicians, physician groups, medical leaders, politicians, and citizens will be assembling in San Diego this Spring. The conference event will be charged with producing a white paper on physician-driven healthcare reform necessities. As with prior challenges issued by America’s Medical Society, the San Diego event is offering an open debate challenge to the AMA and the White House to enter into a televised panel discussion on the merits and pitfalls of the Patient Protection and Affordable Care Act legislation from the physician’s perspective.

Doctor Dorin is a Hopkins-trained, board-certified anesthesiologist, practicing in a large group in San Diego. He is a small business owner, a Commander in the US Navy Reserves, and the Founder/President of America’s Medical Society, Inc., (AMS) a non-profit corporation created to serve and educate physicians and the general public in matters of national health-care reform and medical politics.

After asking 501 practicing physicians about the future of health care in the United States, The Deloitte Center for Health Solutions’ conclusions were hardly surprising: under ObamaCare:

• More people will demand medical care.

• There will be fewer doctors to handle them.

• Those who do will get paid less.

• Those who do will be subject to increasingly onerous regulations.

In its heavy-handed attempt to provide medical coverage to some 34 million Americans, ObamaCare is going to provide it to them for free. But those “free” services are predictably going to increase the demand for medical care while simultaneously reducing the number of doctors available to supply it.

According to the Deloitte study, only one out of four doctors think ObamaCare will reduce healthcare costs, while half of them expect access to such care to be increasingly restricted. Those surveyed think there will be fewer hospitals and fewer physicians. And many of those remaining are likely to take administrative positions in the healthcare industry rather than continuing to provide hands-on primary care of patients.

Three-quarters think that as primary care doctors get busier, patients needing immediate attention will increasingly be sent to emergency rooms, which is likely to extend waiting times there as well. Four out of five are certain that it will be increasingly difficult for their patients to obtain appointments on a timely basis, and those patients will increasingly be forced to seek the services of “mid-level” health care from nurse practitioners and para-medical providers.

The doctors surveyed also are persuaded that because of ObamaCare the “best and brightest” coming into the workforce will likely avoid the healthcare industry. The survey also showed that the older doctors are increasingly looking forward to retiring rather than having to deal with the mass of new regulations and restrictions that are coming from ObamaCare.

This study reflects doctors’ attitudes shown in similar recent studies. For instance, the Fairfield County Medical Association in Connecticut looked at the pending cut in physicians’ reimbursements. In May of 2010 doctors were anticipating a pay cut of 21 percent. If they were implemented at the time, Fairfield estimated that 41 percent of county doctors would stop taking new Medicare patients, and one out of every four would drop Medicare altogether.

Those cuts weren’t implemented at the time, but delayed until January 1, 2012, and the reduction in Medicare reimbursement isn’t 21 percent but 29 percent. Physicians Practice estimated that a physician grossing $1 million from Medicare with 60 percent overhead would see his net income drop by almost 75 percent. As noted, “All medical practices are impacted by Medicare cuts, as most [doctors] tie their fee schedules to Medicare…Cuts to reimbursement will reduce your net income…and the quality of patient care your practice can provide.”

ObamaCare’s regulations are stifling those who are determined to stay in the health care industry. There’s the “Patient-Centered Outcomes Research Institute” which will examine the “clinical effectiveness of medical treatments, procedures, drugs, and medical devices [resulting in] incentives [or] penalties [or more] regulatory requirements.”

And there’s the Physician Quality Reporting Initiative which will require that physicians be “burdened with [additional] time-consuming compliance and reporting requirements.”

Another study, this one done by Athena Health, showed that 79 percent of physicians are “less optimistic about the future of medicine [while] 66 percent indicated that they would consider dropping out of government health programs, and 53 percent would consider opting out of insurance altogether.”

As Robert E. Moffit, Ph.D., Director of the Center for Health Policy at The Heritage Foundation, put it: “ObamaCare…entrenches the worst parts of today’s third-party payment system.”

ObamaCare, if it is enacted in all of its grotesque manifestations, will guarantee higher health care costs (direct and indirect), reduce incentives for physicians to practice medicine, reduce the supply of health care services, and increase the demand for that dwindling supply. None of it makes financial sense, either, as it is not driven by market incentives (profits) but by political expediency and social policy. The best thing that can be said about ObamaCare, if implemented, is that it won’t last long. Using the politically correct term, ObamaCare won’t be “sustainable.” In the meantime, don’t get sick.

The Resurgent Republic poll, obtained in full, exclusively by The Daily Caller, asked registered voters whether they support the 2010 Patient Protection and Affordable Care Act that passed Congress with the president’s support. Forty-eight percent said they opposed the bill while 41 percent indicated they supported it. Independents said they opposed the bill 54 percent to 34 percent.

The survey asks the question a second way, presenting the respondents with two arguments. The first says that the bill has “been good for America” as “[i]t has provided health insurance to those who didn’t have it, is controlling health care costs, and holding the insurance companies accountable.” The other argument says that the bill has been “bad for America” because it has raised “health care costs, cut 400 billion dollars from Medicare, and injected government bureaucrats into health care decisions.”

Respondents again came out opposing the bill, 49 percent to 44 percent. When asked whether their health care costs have gone up, down or stayed the same since the bill’s passage, 50 percent indicated that their costs have gone up. Only two percent indicated that their costs had gone down while 43 percent said their costs have stayed the same.

Presented with two arguments on President Obama’s jobs bill, which was presented as keeping “teachers in the classroom, police and firefighters on the job” and repairing “crumbling infrastructure,” respondents came out in favor of the bill, 50 percent to 44 percent. The opposing argument presented the bill as “exactly like the first Obama stimulus bill that did not work” and just added to the deficit while the unemployment rate went up. However, independents came out in opposition to the bill, 47 percent to 45 percent.

Respondents also came out in favor of “raising taxes on the wealthiest Americans and biggest corporations.” When presented with the argument that “this is the wrong time to raise taxes on anyone” and that raising taxes means “more money going to the government, and less money in the economy that businesses can use to hire workers and create new jobs,” respondents supported the tax increase argument 54 percent to 42 percent. Independents supported increasing taxes on the wealthy and corporations, 53 percent to 44 percent.

When the same pro-tax argument was put against an alternative anti-tax argument, that the “top ten percent of earners already pay over two-thirds of all federal income taxes… and U.S. companies pay a thirty-five percent tax rate, more than most European countries,” the results were similar. Fifty-three percent said they favored raising taxes on the wealthy and corporations while 43 percent said they opposed it.

The poll surveyed 1,000 registered voters from October 30 to November 2 and has a margin of error of plus or minus 3.1 percentage points. Resurgent Republic is a 501(c)(4) organization which, according to its website, “promote[s] conservative free market principles such as lower taxes and economic growth, and support strong national defense policies.”

For two years, I’ve been watching the talking heads discuss unemployment problems. The unemployment numbers began to rise about the time liberal Democrats passed the health care program. What no one’s talking about is that this health care program is the reason our economy hasn’t turned around.

There are other factors, but employers are looking at the extra cost and penalties to insure employees. It was pushed through so quickly no one read it before the vote. Employers’ future expenses are unknown so they lay off workers and won’t hire new employees until they know the “rules.”

Example: Say I have 450 employees. As this plan becomes law, I’ll have to lay off 50 employees and use their salaries to pay the health care coverage for the remaining employees. I’ll be required to pay the health care premiums for these laid-off employees until they find jobs. Depending on business classification, which is determined by the program’s own regulatory board, coverage for a laid-off employee could last 18 months. This for an employee who is not helping my company make a profit. Does this make sense, sending 50 workers to the unemployment lines?

Liberals tell small businessmen “Raise prices to cover the expense!” Businessmen can’t do that; there’s no money moving in the economy for the unemployed to use. They can’t pay current prices.

Just watch, as 2014 gets closer unemployment will rise steadily and spike just before the program is fully enforced.

Dear President Obama, “Now is the time for all American’s to rise up and speak with a loud voice. 2012 will be upon us before we know it and there is no time to waste. This is the time to tell your family and friends to get involved. This is the time to get them informed and this is the time to get them involved. America hangs in the balance my friends. Our very … Read More

Mr. President the Chinese want their Money Back! All the eloquent speeches from the Anointed One will not improve our economy nor is it in any way shape or form going to create jobs. We now have a President that is so full of himself that America is suffering another financial setback that all the Kings men and all the Kings Czars cannot put back together again. The good news is that America is waking up and we have put real American Patriots in … Read More

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